RT  - European Journal of Gynaecological Oncology
ID  - 10.31083/j.ejgo.2021.01.2192
T1  - Using HE4, RMI, ROMA and CPH-I in the differential diagnosis of adnexal masses
A1  - Zhen Shen
A1  - Chen-Chen Zhu
A1  - Li-Li Qian
A1  - Tian-Jiao Zhang
A1  - Min Li
A1  - Jing Zhu
A1  - Da-Bao Wu
A1  - Ying Zhou
A1  - Xing-Sheng Yang
K1  - CPH-I; HE4; Ovarian tumors; RMI; ROMA
YR  - 2021
SP  - 139
AB  - <p><i>Objectives</i>: In order to improve the early diagnosis of ovarian cancer (OC), we evaluated human epididymis secretory protein 4 (HE4), the risk of malignancy index (RMI), the risk of ovarian malignancy algorithm (ROMA), and the Copenhagen Index (CPH-I) in their ability to predict the risk of adnexal masses being malignant, and in discriminating between serous and mucinous ovarian tumors. <i>Methods</i>: A study consisting of 509 patients who were diagnosed with benign, borderline, and malignant adnexal tumors was conducted. We analyzed the values of HE4, RMI, ROMA, and CPH-I. In addition, CA125, CEA, CA125/CEA ratio, CA199, and CA125/CA199 ratio were also assessed to determine their predictive values to diagnoses serous or mucinous ovarian tumors. <i>Results</i>: To differentiate between benign and borderline ovarian tumors, we evaluated RMI and CPH-I scores which showed high AUC (0.7593, and 0.7128, respectively), but neither of them showed both high sensitivity and specificity. When discriminating benign and malignant tumors, RMI and CPH-I performed the best for premenopausal women; whereas ROMA and HE4 performed the best for postmenopausal women. Patients with values above the cutoff for CA125 (<inline-formula><math><mo>&gt;</mo></math></inline-formula> 328.3 U/mL), CA125/CEA (<inline-formula><math><mo>&gt;</mo></math></inline-formula> 82.26), and CA125/CA199 (<inline-formula><math><mo>&gt;</mo></math></inline-formula> 5.633), were more likely to be diagnosed with serous carcinoma. Whereas those with higher values for CEA (<inline-formula><math><mo>&gt;</mo></math></inline-formula> 3.7 <inline-formula>μ<math><mi>μ</mi></math></inline-formula>g/L) and CA199 (<inline-formula><math><mo>&gt;</mo></math></inline-formula> 27.81 ng/mL) were more likely to have a mucinous carcinoma. <i>Conclusion</i>: RMI and CPH-I for premenopausal women, ROMA and RMI for postmenopausal women were reliable indicators to differentiate between women with benign versus malignant tumors. In addition, the ratios CA125/CEA and CA125/CA199 could be used to distinguish serous from mucinous ovarian carcinomas.</p><p><br></p>